Challenges of data quality for the management of prostate cancer in Tanzania: A hurdle towards improving the quality of service

Abstract

Data quality in clinical notes is crucial for providing quality prostate cancer services, especially in countries with weak health systems and a growing burden of non-communicable diseases like prostate cancer. Poor data quality can lead to inefficient services, delayed treatment, and compromised patient outcomes. The objective of this study was to examine the quality of clinical notes for prostate cancer patients treated at five tertiary hospitals in Tanzania from January to December 2022. A sequential mixed-method approach was employed, combining quantitative and qualitative data collection. Patients' level information from electronic and manual clinical notes were extracted and reviewed. In-depth interviews were conducted among 25 healthcare providers to explore data quality challenges in clinical notes. Quantitative data analysis used descriptive analysis via SPSS 27 software to determine data completeness and accuracy. In-depth interviews were conducted among 25 healthcare providers to explore data quality challenges. Qualitative data analysis utilized thematic analysis with hybrid inductive and deductive reasoning via NVivo 14 software. Clinical notes for prostate cancer management had poor quality. While the overall accuracy of documented variables was high at 1,494 (99.4%), documentation of key clinical variables was low; specifically, the clinical stage was documented in only 1,052 (70.0%) clinical notes, and the Gleason score in 923 (61.4%). Age, clinical presentation, and type of treatment showed high completeness. Themes established included lack of knowledge on data quality, poor integration of data, shortage of human resources for health, lack of supervision and the coexistence of electronic and manual record systems. The Health Information Management System and hospital-based cancer registries were not integrated. Documentation rates for clinical stage and Gleason score in the clinical notes of patients with prostate cancer were low in Tanzania. Improving the quality of clinical notes requires collaborative efforts among stakeholders focusing on structural reforms and capacity building of personnel.